Öztürk Bilgin
Neurology Department, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkiye.
Turk J Med Sci. 2024 Oct 31;54(7):1428-1437. doi: 10.55730/1300-0144.5928. eCollection 2024.
Neurological disorders encompass a complex and heterogeneous spectrum of diseases affecting the brain, spinal cord, and peripheral nervous system, each presenting unique challenges that extend well beyond primary neurological symptoms. These disorders profoundly impact cardiovascular health, prompting an intensified exploration into the intricate interconnections between the neurological and cardiovascular systems. This review synthesizes current insights and research on cardiovascular comorbidities associated with major neurological conditions, including stroke, epilepsy, Parkinson's disease, multiple sclerosis, and Alzheimer's disease. The cardiovascular sequelae of these neurological disorders are multifactorial. For instance, strokes not only predispose individuals to arrhythmia and heart failure but also exacerbate preexisting cardiovascular risk factors. Similarly, epilepsy is associated with autonomic dysregulation and an elevated risk of sudden cardiac death, underscoring the necessity for vigilant cardiac monitoring in affected individuals. Parkinson's disease manifests with orthostatic hypotension and cardiac sympathetic denervation, significantly contributing to morbidity. Additionally, multiple sclerosis and Alzheimer's disease exhibit cardiovascular autonomic dysfunction and heightened cardiovascular risk, underscoring the need for proactive management strategies. Mechanistically, these conditions disrupt autonomic nervous system regulation, induce chronic inflammation, and may share genetic susceptibilities, each contributing to cardiovascular pathology. Effective management of these complexities requires an integrative approach that includes risk factor modification, pharmacotherapy, lifestyle interventions, and comprehensive patient education. Future research directions include identifying novel therapeutic targets, conducting large-scale clinical trials, and investigating genetic biomarkers to individualize treatment strategies. By addressing the multifaceted interactions between neurological disorders and cardiovascular health, healthcare providers can optimize patient care, reducing cardiovascular morbidity and mortality in this vulnerable population.
神经系统疾病涵盖了一系列影响大脑、脊髓和周围神经系统的复杂且异质性的疾病，每种疾病都带来了远远超出原发性神经症状的独特挑战。这些疾病对心血管健康产生了深远影响，促使人们对神经和心血管系统之间的复杂相互联系进行更深入的探索。本综述综合了当前关于与主要神经系统疾病相关的心血管合并症的见解和研究，这些疾病包括中风、癫痫、帕金森病、多发性硬化症和阿尔茨海默病。这些神经系统疾病的心血管后遗症是多因素的。例如，中风不仅使个体易患心律失常和心力衰竭，还会加剧已有的心血管危险因素。同样，癫痫与自主神经调节异常和心源性猝死风险升高有关，这突出了对受影响个体进行警惕的心脏监测的必要性。帕金森病表现为体位性低血压和心脏交感神经去神经支配，对发病率有显著影响。此外，多发性硬化症和阿尔茨海默病表现出心血管自主神经功能障碍和心血管风险增加，这突出了积极管理策略的必要性。从机制上讲，这些疾病会破坏自主神经系统调节，引发慢性炎症，并且可能存在共同的遗传易感性，每种因素都对心血管病理产生影响。有效管理这些复杂性需要一种综合方法，包括危险因素修正、药物治疗、生活方式干预和全面的患者教育。未来的研究方向包括确定新的治疗靶点、开展大规模临床试验以及研究基因生物标志物以实现治疗策略的个体化。通过解决神经系统疾病与心血管健康之间的多方面相互作用，医疗保健提供者可以优化患者护理，降低这一脆弱人群的心血管发病率和死亡率。
